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Lupus
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*Blood Thinners
*Ovarian Cysts
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*PHENINDIONE
*WARFARIN
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Massive ovarian haemorrhage complicating oral anticoagulation in the Antiphospholipid Syndrome: a report of three cases

Elodie Crétel

Patrice Cacoub

Du Le Thi Huong

Service de Médecine Interne, Groupe Hospitalier Pitié-Salpétriére, Paris, France

Anne Gompel

Service de Gynécologie, Hôtel Dieu, Paris, France

Zahir Amoura

Jean-Charles Piette

Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

We report three cases of severe haemorrhagic rupture of luteal ovarian cyst requiring surgical haemostasis in young women treated with long-term oral anticoagulation for antiphospholipid syndrome (APS) who used no contraception. At the time of bleeding, the international normalized ratios were 3.78, 4.24, and 7.11. Anticoagulation was resumed post-operatively, in association with antigonadotropic progestins to induce ovulatory suppression. A systematic use of these progestins should probably be discussed in young women receiving long-term warfarin for APS. Ovarian haemorrhage must be considered when such patients develop acute abdominal pain.

Key Words: antiphospholipid syndrome • oral anticoagulation • ovarian haemorrhage

Lupus, Vol. 8, No. 6, 482-485 (1999)
DOI: 10.1177/096120339900800614
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